Thursday, July 29, 2021



GUTLESS UCP BLAMES THE DOCTOR FOR THEIR PANDEMIC STUPIDITY


Alberta's top doctor came up with plan to lift all COVID-19 orders: health minister

CALGARY — Alberta's health minister says it was the idea of the province's chief medical health officer to end isolation requirements for those who test positive for COVID-19 or who have been in close contact with someone who has.
© Provided by The Canadian Press

Tyler Shandro said Dr. Deena Hinshaw came to the government with the plan. He said the government agreed with science and data supporting it and wanted to respect the independence of her position.


“It came from Dr. Hinshaw,” Shandro said Thursday when asked about the province's strategy. “This is work that was developed by those who are in public health."

He acknowledged concerns about moving forward so quickly. “We have many different opinions in the medical community and that’s to be expected and that’s encouraged.”

He also said that while Alberta is alone in Canada in the approach, others will eventually follow suit.


"We are leading the way in moving to the endemic (phase of the COVID-19) response. We've led the way throughout in the response to the pandemic quite frankly."

Hinshaw has always said she presents scientific evidence, numbers and trends, but the final decision on how to respond to pandemic developments lies with the government.

Close contacts of positive cases are no longer notified of exposure by contact tracers, nor are they required to isolate. The government has also ended asymptomatic testing.

As of Aug. 16, individuals who test positive won't be legally required to isolate either — although it will still be recommended. Isolation hotels will close and quarantine supports will end.

Reaction to Hinshaw's announcement Wednesday was swift and critical — much of it on Twitter. Opposition politicians, the medical community and private citizens all weighed in.

On Thursday, Dr. Daniel Gregson, an infectious disease specialist with the University of Calgary, said the government's decision to end mandated isolation is irresponsible.

“The message we’re sending is that if you have an infection with COVID, or think you might have an infection with COVID, you can do whatever you want," said Gregson. "I would not agree with that."

Video: Albertans losing trust in province's COVID-19 messaging, Edmonton doctor says (cbc.ca)

He said a fourth wave is inevitable, primarily among young and healthy individuals. “We are going to see a bump in our hospitalizations. The question is how much?”

Calgary Mayor Naheed Nenshi said it's inconceivable Alberta is eliminating almost all of its remaining COVID-19 public health orders as cases climb in the province.

"It is the height of insanity," Nenshi said.


"It is putting the health of Albertans at risk to stop contact tracing, to stop testing people for the coronavirus and to become one of the first — if not the first — jurisdictions in the world to say that people who have tested positive, who are infectious, can just go about their lives."

Nenshi said if he were in another jurisdiction he would contemplate travel restrictions on Albertans starting Aug. 16.

"I'm aware of no science that backs this up," he said. "Even the most fervent of the anti-maskers wouldn't say (to) unleash people who are actually infectious into the population."


Nenshi said he worries the decision to lift the orders is politically motivated and has nothing to do with science.

Rida Abboud also questioned the province's motives.

Abboud, who teaches at Calgary's Mount Royal University and has a child starting kindergarten in the fall, said the United Conservatives are taking a gamble and the odds aren't in their favour.

"I feel like I'm sending my child into the COVID Wild Wild West," said Abboud. "It really feels like this government has no interest whatsoever in supporting families in ... diminishing the risks to anyone under the age of 12 who can't get vaccinated."

She's also worried about returning to the classroom come September. Abboud said poorly ventilated rooms and teaching an age cohort with lower vaccination rates is concerning, especially as it will be unknown who's infected.

"This government likes to gamble on a lot of different approaches. They've lost in many ways and this is, I think, unfortunately, another one," she said. "It's just so shocking and saddening that it's on the backs of parents and women, in particular."

Opposition NDP Leader Rachel Notley urged the government to reverse course with necessary resources.

“This isn’t fair to Albertans. It’s not fair for them to be exposed and not know,” Notley said. “It’s also quite reasonable to keep asking Albertans who are infected to stay home until they are no longer contagious."


She said the changes will do little to encourage uptake of vaccines.

This report by The Canadian Press was first published July 29, 2021.

— With files from Dean Bennett in Edmonton

Bill Graveland and Alanna Smith, The Canadian Press

 

Hemp goes ‘hot’ due to genetics, not environmental stress

Peer-Reviewed Publication

CORNELL UNIVERSITY

ITHACA, N.Y. – Contrary to claims that environmental or biological stresses cause an increase in THC production in hemp, a new Cornell University study finds no evidence that stress on hemp plants increases THC concentrations or ratios of CBD to THC.

Growing hemp for CBD (cannabidiol) is a burgeoning industry, but when hemp contains more than the legal limit of THC, the plants can test “hot.” State and federal regulations classify hemp as containing 0.3% or less THC; when plants exceed that amount, farmers can lose their entire crop.

“One of our goals in our research and in fulfilling our extension mission is to reduce the risks to growers as much as possible,” said Larry Smart, senior author of the study and professor in the horticulture section of the School of Integrative Plant Science in the College of Agriculture and Life Sciences. “With this research, growers should feel some comfort that stresses do not seem to have a strong effect on changing the ratio of CBD to THC.”

In the study, lead author Jacob Toth, a graduate student in Smart’s lab, created a series of plots in Geneva, New York, that included control plots and five stress treatments applied to three genetically unrelated high-CBD hemp cultivars. Stress treatments included flood conditions; exposure to a plant growth regulator called ethephon, used to promote fruit ripening; powdery mildew; herbicide; and physical wounding. They then tested THC and CBD content over a four-week period when the flowers matured.

“What we found over the weeks that we were sampling, the amounts of CBD and THC went up proportionately in all of these different cultivars for all of these different stresses,” Toth said.

By week four, at harvest time, they found that nearly every plant (except those treated with herbicide, which were nearly dead) produced the expected ratio of CBD to THC, with high levels of CBD corresponding to levels of THC above the 0.3% THC threshold.

The study further proves that genetics, rather than environment, determine the THC content and CBD to THC ratios in hemp, Smart said.

More research and breeding is needed to select appropriate genetics that lead to high CBD but low THC, and regulatory testing may be needed earlier, before harvest and before plants reach high THC levels, Toth said.

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The research from Smart’s lab has assisted the U.S. Department of Agriculture in developing hemp regulations that focus more on genetics rather than environmental stress leading to noncompliant THC levels.

The study published July 28 in the journal Global Change Biology-Bioenergy.

For additional information, see this Cornell Chronicle story.

 

 

Study: Public private partnerships better at promoting equity than widely assumed


University of Maryland researchers find P3 projects set higher DBE goals compared to “design-bid-build”

Peer-Reviewed Publication

UNIVERSITY OF MARYLAND

Adjusted DBE Goals and Adjusted DBE Attainment 

IMAGE: DISTRIBUTIONS OF ADJUSTED DBE GOAL AND ADJUSTED DBE ATTAINMENT BY DELIVERY METHOD view more 

CREDIT: A. JAMES CLARK SCHOOL OF ENGINEERING. UNIVERSITY OF MARYLAND

COLLEGE PARK, Maryland--Public private partnerships have a better track record in promoting equity than many assume, researchers at the University of Maryland’s (UMD) A. James Clark School of Engineering have found.

In fact, they generally set higher U.S. Department of Transportation’s (USDOT) Disadvantaged Business Enterprise (DBE) program goals than do Design-Bid-Build (DBB) projects, the findings suggest.

The newly-released study, conducted by UMD civil and environmental engineering professor Qingbin Cui and doctoral student Kunqi Zhang, and published this month by Transportation Research Record, is the first ever to empirically test how different delivery methods correlate with the setting and attainment of DBE goals--typically expressed in terms of the percentage of contract dollars expected and actually awarded to minority and women-owned businesses that participate in federally-funded transportation projects.

Drawing from the U.S. Major Highway Projects Database, Cui and Zhang sampled 134 federally assisted contracts. Linear regression models created by the team showed that two delivery methods--Design Build/Construction Manager at Risk and P3--outpace DBB in setting equity-related goals.

“In this case, conventional wisdom turns out to be wrong,” Cui said. 

In Ohio, for instance, value-weighted DBE goals stood at 14.3% for P3, 10.7% for Design Build/Construction Manager at Risk, and 9.2% for DBB; in Texas, the numbers were 12.8%, 9.9%. And 8.0%. Similar trends were found nationwide, and DBE goals were also found to be the most robust predictor of actual DBE attainment.

Contract size is an important factor, Cui and Zhang found: the larger the contract, the more opportunities for subcontractors, in turn fostering a greater capacity to meet DBE goals. And both P3 and DB/CMAR dwarf DBB when it comes to contract size, with average amounts of $954.2 million, $466.6 million, and $89.1 million, respectively.

“Larger-scale contracts offer more opportunities for business that might otherwise not be able to get a foot in the door,” Zhang said.

P3 projects may also have an incentive to promote diversity and equity because of the amount of public scrutiny these large, high profile projects often generate. “There’s a public relations component,” Cui said. “Companies involved in these projects are in the media spotlight and they want to be seen as doing the right thing.”

Cui and Zhang conducted their research in partnership with the Maryland Transportation Institute, a UMD research hub that brings together experts from across the University of Maryland System.

The primary source for the study--the U.S. Major Highway Projects Database--was also developed at UMD, under Cui’s direction. Unveiled in 2019, the tool covers nearly two decades of highway projects and allows researchers a ready means to make cross-project comparisons.

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The A. James Clark School of Engineering at the University of Maryland serves as the catalyst for high-quality research, innovation, and learning, delivering on a promise that all graduates will leave ready to impact the Grand Challenges of the 21st century. The Clark School is dedicated to leading and transforming the engineering discipline and profession, to accelerating entrepreneurship, and to transforming research and learning activities into new innovations that benefit millions.

JOURNAL

Transportation Research Record

DOI

10.1177/03611981211031210

Common floral bacteria can induce pollen germination


The bacteria can double amount of protein released from pollen


Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - DAVIS

Pollen with Acinetobacter 

IMAGE: THIS IMAGE SHOWS WHAT POLLEN LOOKS LIKE WITH ACINETOBACTER, A GENUS OF BACTERIA COMMON IN FLOWERS. MANY OF THE POLLEN GRAINS ARE GERMINATING AND BURSTING. view more 

CREDIT: SHAWN CHRISTENSEN, UC DAVIS

Certain species of floral bacteria can enhance pollen germination, according to a study published today from the University of California, Davis in the journal Current Biology.

“This is the first paper documenting stimulation of pollen germination by non-plants,” said first author Shawn Christensen, a doctoral candidate in associate professor Rachel Vannette’s laboratory in the Department of Entomology and Nematology. “Nectar-dwelling Acinetobacter bacteria stimulate protein release by inducing pollen to germinate and burst, benefitting Acinetobacter.”

Acinetobacter is a genus of bacteria very common in flowers. They are usually among the most abundant bacteria in nectar and are often found on other floral tissues, including pollen and stigmas.

The authors collected California poppies from the UC Davis Arboretum and Public Garden, and Acinetobacter primarily from nearby Stebbins Cold Canyon Reserve, which is part of the UC Natural Reserve System.

“Despite the essential nutritional role of pollen for bees and other pollinators, we still know very little about how pollen is digested by anything,” Christensen said. “We found out that certain bacteria in flowers, Acinetobactercan send a chemical signal to pollen that hijacks its systems and tells it to open the door from the inside--releasing protein and nutrients for the bacteria.”

Christensen said the bacteria can double the amount of protein released from pollen. That makes it important for bacterial growth, but it could also be exploited by bees or other pollen consumers to get more nutrition from their food.

The question of how organisms actually eat pollen has been a long-standing one. Pollen is well-protected by layers of resistant biopolymers, and it's unclear how pollen-eaters get through those protective layers.

“The bacteria have found what looks like a fairly unique and very effective way to get nutrients, which are otherwise scarce in a flower environment,” said Vannette, a UC Davis Hellman Fellow. “It's a very neat biological trick. This finding opens the door for a lot of exciting new research: How do the bacteria do it? Given that Acinetobacter is often found on pollinators, do pollinators benefit from this? Could bacterial action on pollen make it more, or less, beneficial to pollen-eaters? And what about plants? Could the bacteria be reducing pollination by causing pollen to germinate before fertilization? We aim to investigate many of these possibilities in future work.” 

Additional co-authors include Ivan Munkres of UC Davis.

The research was funded by the National Science Foundation, Davis Botanical Society, and UC Davis Microbiology Graduate Group Diversity Equity and Inclusion Award.

 











 

Has the billion dollar crusade to eradicate polio come to an end?


Special report explores WHO’s shift away from global eradication

Peer-Reviewed Publication

BMJ

The polio juggernaut, which has skidded past eradication deadline after deadline, seems to have finally run out of fuel, suggests an investigation published by The BMJ today.

Journalist Robert Fortner reveals that the World Health Organization (WHO) has already fired 500 staff on the polio programme - “perhaps ending a decades long, multibillion dollar crusade engineered by some of the most powerful actors in global health.”

According to Fortner, not even the Bill & Melinda Gates Foundation - topmost funder of polio initiatives and behind only the US government as the largest funder of WHO - knew about these plans.

Since the effort to eradicate polio began in 1988, the Global Polio Eradication Initiative (GPEI) has pushed polio to near annihilation, reducing cases by 99.99%.

Yet the GPEI has been perched, exhaustingly and expensively, at the cusp of success for years, writes Fortner. In 2017, for example, Bill Gates predicted that “humanity will see its last case of polio this year.” Instead, cases surged.

The pandemic put polio efforts on hiatus for several months in 2020. Then in December, WHO decided to speed up integration of the polio programme into existing immunisation services - something that for decades has been considered anathema.

This was followed by WHO’s regional office for Africa (AFRO) firing some 500 polio programme staff - surprising GPEI’s partner groups and donor nations including the UK’s Foreign, Commonwealth & Development Office, and the US Agency for International Development (USAID).

The GPEI explicitly separated polio from routine immunisation because eradication requires very high coverage rates: 90% or more. Yet some argue that the money lavished on polio has left millions of children vulnerable to other, often deadly, vaccine preventable diseases, such as measles. 

Polio funds from abroad have also led to local brain drains - into eradication and away from local and locally funded health priorities.

Aidan O’Leary, who took over as director for polio eradication at WHO after the December transition decision had been taken, describes GPEI partners’ commitment to eradication as “pretty unequivocal.” 

But Fortner notes that the once indomitable tone now seems muted, and he points to funding cuts and challenges in Afghanistan and Pakistan (the two remaining countries where polio remains endemic) as factors that could sink eradication.

Even if we bravely assume adequate funding, would integrated health service delivery also deliver eradication, he asks? 

Integrated delivery has “not ever really been tested for an eradication programme,” says Nicholas Grassly, an epidemiologist at Imperial College London and an independent adviser to GPEI. 

Meanwhile, a paper published in The Lancet earlier this year, entitled “Polio eradication at the crossroads” suggests that eradication of all poliovirus from the planet has never actually been possible. The reasons include the likelihood of containment breaches of the virus kept in scientific facilities and the ability to synthesise polio.

The problems aren’t new, but the authors use them as the basis for a new policy direction, notes Fortner: “The objective of our efforts should be to eliminate the disease, not the virus.” We can still “eradicate polio” because in lay terms both the disease and the virus go by the same name. The means proposed, much as envisaged in the new polio strategic plan, are “global immunisation programmes.”

Zulfiqar Bhutta, a paediatrician at Aga Khan University, says that GPEI “may need to call the new reality the new eradication.”

 

 #LEGALIZEDRUGS

Ease access to opioid addiction medication, new research suggests


OHSU evidence review encourages the use of primary care clinics to improve access to methadone treatment for opioid use disorder

Peer-Reviewed Publication

OREGON HEALTH & SCIENCE UNIVERSITY

With overdose deaths surging during the COVID-19 pandemic, new findings from researchers at Oregon Health & Science University suggest easing access to a key medication to treat addiction.

An evidence review published today in the American Journal of Psychiatry recommends making methadone more widely available through office-based visits with primary care physicians. The current federal standard largely requires it to be administered only through specialized clinics.

The study is one of five evidence reviews led by Dennis McCarty, Ph.D., professor emeritus of public health and preventive medicine in the OHSU School of Medicine and the OHSU-Portland State University School of Public Health, and Roger Chou, M.D., director of the OHSU Pacific Northwest Evidence-Based Practice Center.

“Methadone is the most highly regulated medical treatment in the U.S.,” McCarty said.

It is one of three medicines approved by the Food and Drug Administration to treat opioid dependence, along with buprenorphine and naltrexone. Methadone is a full agonist, meaning it fully acts on the same targets in the brain as prescription opioids or heroin. Buprenorphine is a partial agonist, and naltrexone is an opioid antagonist. Methadone and buprenorphine inhibit opioid withdrawal symptoms, while naltrexone blocks the euphoric effect of opioids.

Federal regulations originally established in 1971 require methadone to be administered through federally certified opioid treatment programs, to reduce the risk of overdose among people who are less tolerant as well as the risk of patients “diverting” it to sell to people without a prescription.

The study published today suggests the need to revisit regulations requiring methadone to be administered only in specialized clinics. McCarty noted that allowing methadone to be administered and dispensed in primary care clinics will reduce hefty transportation costs currently paid by Medicaid while also greatly improving access and convenience for patients with addiction.

“If you’re on the coast and you have to drive to a methadone clinic in Roseburg, that’s a two-hour drive,” McCarty said.

McCarty and Chou found 18 studies of methadone completed in office-based settings such as primary care, and that patients in those settings had better treatment retention rates and greater satisfaction compared to patients who received care in opioid treatment programs. However, their study was limited by the fact that only highly stable patients were recruited to participate in these studies.

It remains to be seen whether it would work for all patients.

“We don’t know, because nobody’s tried it,” McCarty said. “Some patients stabilize very quickly. They have a job, they have a family and their life is in pretty good order.”

The nation’s opioid epidemic has worsened during the pandemic.

Provisional data from the U.S. Centers of Disease Control and Prevention found the number of drug overdose deaths in the United States exceeded 90,000 for the calendar year that ended in December, up 29% from the previous year.

The OHSU research was supported by Arnold Ventures, which contracted with McCarty and Chou to conduct a broad review of methadone policy research with recommendations for changes in federal regulations.

The work culminated in five publications, including the one published today in the American Journey of Psychiatry.

Each study generally suggested easing access to methadone:

  • Interim methadone: Federal regulations require patients to be assigned to a counselor at the initiation of methadone treatment, with an exception granted for clinics with a full caseload. They found six studies that consistently found that patients treated through this exception found quicker access to medication, decreased drug use, enhanced retention and better outcomes than those forced to wait. Published online in the journal Drug and Alcohol Dependence.
  • Mobile methadone medication units: In a study published online in the Journal of Substance Abuse Treatment, researchers found only four poorly controlled studies regarding the effectiveness of mobile medication units allowed by the U.S. Drug Enforcement Administration to administer and dispense methadone in rural communities and other underserved locations. They conclude that new regulations should create opportunities for more research and economic analysis of mobile services, which do appear to improve access to people living in rural areas, living with housing instability and having more severe cases of opioid use disorder.
  • Adolescents and young adults: An OHSU review in the Journal of Addiction Medicine found that access to mediations for opioid use disorder increased with age, and that federal regulations should be reviewed to encourage development of age-appropriate services for younger people with opioid use disorder.
  • Telemedicine: With the onset of the COVID-19 pandemic, federal authorities loosened regulations to allow treatment programs to use telehealth services. OHSU’s review of studies conducted to date suggest that telemedicine outcomes were comparable to in-person care, and that access to telemedicine care should become routine in opioid treatment programs and in primary care settings.

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Study highlights urgent need to build vaccine confidence within racial and ethnic minority communities


Racial and ethnic disparities in vaccine uptake have persisted over the last decade, highlighting the urgent need to achieve equity in immunization rates, report scientists in the American Journal of Preventive Medicine

Peer-Reviewed Publication

ELSEVIER

Study highlights urgent need to build vaccine confidence within racial and ethnic minority communities 

IMAGE: RACIAL AND ETHNIC DISPARITIES IN VACCINE UPTAKE (INCLUDING INFLUENZA, PNEUMOCOCCAL, SHINGLES, AND TDAP VACCINATIONS) HAVE PERSISTED FROM 2010 TO 2019. view more 

CREDIT: AMERICAN JOURNAL OF PREVENTIVE MEDICINE

Ann Arbor, July 29, 2021 – Promoting health equity in immunization rates for the new vaccines against COVID-19 during the pandemic is critical, as individuals from racial and ethnic minority groups and adults living in low-income communities are disproportionately affected by COVID-19, as well as influenza and other vaccine-preventable diseases, according to investigators. Concerted efforts are urgently needed to achieve equity in immunization rates, reports a new study in the American Journal of Preventive Medicine, published by Elsevier.

Vaccination has substantially decreased deaths due to vaccine-preventable diseases in children to 300 per year in the United States. However, more than 42,000 adults die from vaccine-preventable diseases every year. Influenza causes approximately 140,000710,000 hospitalizations and about 12,000–61,000 deaths in adults annually, with vulnerable communities at higher risk of influenza hospitalization. Pneumococcal disease causes about 242,000 hospitalizations and 16,000 deaths in adults aged 65 years or more every year. Coronavirus disease (COVID-19) continues to spread across the world and affect millions of individuals, especially among racial and ethnic minority groups.

“Currently, the biggest public health concern we are facing is the COVID-19 pandemic, for which we now have safe and effective vaccines available in the USA,” explained investigators Kosuke Kawai, ScD, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA, and Alison Tse Kawai, ScD, RTI Health Solutions, Waltham, MA, USA. “Unfortunately, as we observed for vaccines against influenza, pneumococcal, shingles, and Tdap, a combination vaccine that protects against tetanus, diphtheria, and pertussis, adults from racial and ethnic minorities have had lower rates of COVID-19 vaccine uptake.”

The objective of this study was to examine trends in adult vaccination coverage by race/ethnicity and socioeconomic status from 2010 to 2019. Investigators assessed trends over time in vaccination coverage for influenza, pneumococcal disease, herpes zoster, and Tdap using the National Health Interview Surveys (NHIS) from 2010 to 2019. The NHIS is a US-wide survey of the civilian non-institutionalized population conducted through in-person household interviews. It collects data on demographics, health status, insurance coverage, healthcare access, and health behaviors from a nationally representative sample.

The current study shows that racial and ethnic disparities in vaccine uptake (including influenza, pneumococcal, shingles, and Tdap vaccinations) have persisted over the last decade in adults.  Black and Hispanic individuals had lower uptake of vaccination than White individuals. Socioeconomic disparities in influenza vaccine uptake have moderately narrowed among adults 18–64 years of age between 2010 and 2019, possibly because of the Affordable Care Act. However, socioeconomic disparities in vaccine uptake have persisted among adults 65 years of age and older. 

“Although the COVID-19 pandemic is the primary public health concern at the moment, our findings also serve as a reminder of the importance of continuing to strive towards equity in immunization rates for vaccines against other vaccine-preventable diseases,” commented the investigators. “More than 42,000 adults die from vaccine-preventable diseases in the US (not including COVID-19) every year. In addition to building trust and vaccine confidence through community engagement, reducing cost barriers especially for adults 65 years or older and implementing provider/patient reminder and recall systems using an Immunization Information System, could narrow the disparities in immunization rates.”

 

THIRD WORLD USA

New study: Half of Americans living with diabetes may be consuming less than the recommended amount of protein, which is associated with greater physical limitations


Patients with diabetes who did not meet the recommended daily intake of protein had greater physical limitations, which together may suggest an increased risk of muscle loss

Peer-Reviewed Publication

GCI HEALTH NY

ABBOTT PARK, Ill., Jul. 29, 2021 – A new study conducted by The Ohio State University and Abbott showed that half of the adults surveyed living with diabetes did not consume the daily recommended intake of protein, which is associated with lower diet quality, increased carbohydrate intake, and greater physical limitations. The study highlights protein intake as an essential and often overlooked consideration in meeting the nutritional needs of people living with diabetes and its importance in supporting strength and mobility.  

“We’ve long studied the impact of sugar consumption in people living with diabetes, but new data shed light on the critical association between low protein intake and diabetes,” said Christopher Taylor, Ph.D. R.D., lead researcher, and professor of Medical Dietetics at The Ohio State University School of Health and Rehabilitation Sciences. “Diabetes is associated with a risk for developing low muscle mass, which can lead to falls and other injuries. That's why protein consumption—and awareness of the need for it—is critical to maintaining muscle mass and preserving functional mobility, which can help people living with diabetes live stronger overall lives.”

Published in the scientific journal of human nutrition, Nutrients, the retrospective cross-sectional analysis examined data from the National Health and Nutrition Examination Survey (NHANES) collected between 2005 and 2016 from more than 23,000 adults in the U.S. Key findings from the analysis include:

  • People living with diabetes who did not consume the daily recommendation of protein on the day of intake reported a higher prevalence of physical limitations, including difficulty completing basic movements, such as stooping, crouching, kneeling, standing for long periods, and pushing or pulling large objects.
  • Adults with diabetes who met protein recommendations had better overall diet quality, more closely meeting dietary recommendations for total daily intake of vegetables, whole grains, dairy and added sugars.
  • People with diabetes who exhibited low protein intake showed significantly poorer nutrient density, lower overall diet quality, and consumed 12.5% more carbohydrates, which may negatively impact glucose levels.

“This study highlights the importance of the quality of foods in our diet as well as the quantity of nutrients we need daily—both of which have a significant impact on health and mobility, especially for people living with diabetes,” said Sara Thomas, Ph.D., R.D.N., a research scientist, and dietitian at Abbott specializing in diabetes. “Nutrition education will help people successfully manage a condition like diabetes, emphasizing the need to achieve a well-rounded diet with the right nutrients and avoid foods that are detrimental to optimal health.” 

Understanding the recommended daily intake requirements for macronutrients like protein, fat and carbohydrates, and more than 25 vitamins and minerals can be complicated. The National Academy of Medicine, formerly the Institute of Medicine, developed the Dietary Reference Intakes (DRIs), a set of reference values used to plan and assess nutrient intakes and provide recommended consumption levels. The DRIs recommend adults consume 0.36 grams of protein per pound of body mass each day, which means that a person weighing 150 pounds should consume 54 grams of protein per day. The DRI calculator can help determine individual nutrient needs for overall micro-and macronutrient intakes. Individuals should discuss results with a healthcare professional.

“This new research underscores Abbott's long-time focus on diabetes care and will help us continue to support people living with this condition,” said Matt Beebe, divisional vice president and general manager of Abbott’s U.S. nutrition business. “At Abbott, we are continually working to advance our understanding so that we can enable a more holistic approach to managing diabetes from the point of diagnosis with industry-leading glucose monitoring and world-class nutrition.”

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About Abbott

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 109,000 colleagues serve people in more than 160 countries.

Connect with us at www.abbott.com, on LinkedIn at www.linkedin.com/company/abbott-/, on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews.

ANCIENT GRAINS

Millet based diet can lower risk of type 2 diabetes and help manage blood glucose levels

Peer-Reviewed Publication

INTERNATIONAL CROPS RESEARCH INSTITUTE FOR THE SEMI-ARID TROPICS (ICRISAT)

Pearl millet 

IMAGE: A FARMER SHOWS DHANSHAKTI, INDIA'S FIRST BIOFORTIFIED PEARL MILLET. view more 

CREDIT: ICRISAT

A new study has shown that eating millets can reduce the risk of developing type 2 diabetes and helps manage blood glucose levels in people with diabetes, indicating the potential to design appropriate meals with millets for diabetic and pre-diabetic people as well as for non-diabetic people as a preventive approach.

Drawing on research from 11 countries, the study published in Frontiers in Nutrition shows that diabetic people who consumed millet as part of their daily diet saw their blood glucose levels drop 12-15% (fasting and post-meal), and blood glucose levels went from diabetic to pre-diabetes levels. The HbA1c (blood glucose bound to hemoglobin) levels lowered on average 17% for pre-diabetic individuals, and the levels went from pre-diabetic to normal status. These findings affirm that eating millets can lead to a better glycemic response.

The authors reviewed 80 published studies on humans of which 65 were eligible for a meta-analysis involving about 1,000 human subjects, making this analysis the largest systematic review on the topic to date. “No one knew there were so many scientific studies undertaken on millets’ effect on diabetes and these benefits were often contested. This systematic review of the studies published in scientific journals has proven that millets can keep blood glucose levels in check and reduce the risk of diabetes. It has also shown just how well these smart foods do it,” said Dr. S Anitha, the study’s lead author and a Senior Nutrition Scientist at ICRISAT.

Millets, including sorghum, were consumed as staple cereals in many parts of the world until half a century ago. Investments in a few crops such as rice, wheat and maize, have edged nutritious and climate-smart crops like millets out of the plate.

“Awareness of this ancient grain is just starting to spread globally, and our review shows millets having a promising role in managing and preventing type 2 diabetes. In the largest review and analysis of research into different types of millet compared to other grains such as refined rice, maize and wheat we found that millets outperform their comparison crops with lower GI and lower blood glucose levels in participants,” observed Professor Ian Givens, a co-author of the study and Director at University of Reading’s Institute of Food, Nutrition and Health (IFNH) in the UK.

According to the International Diabetes Association, diabetes is increasing in all regions of the world. India, China and the USA have the highest numbers of people with diabetes. Africa has the largest forecasted increase of 143% from 2019 to 2045, the Middle East and North Africa 96% and South East Asia 74%. The authors urge the diversification of staples with millets to keep diabetes in check, especially across Asia and Africa.

Strengthening the case for reintroducing millets as staples, the study found that millets have a low average glycemic index (GI) of 52.7, about 36% lower GI than milled rice and refined wheat, and about 14-37 GI points lower compared to maize. All 11 types of millets studied could be defined as either low (<55) or medium (55-69) GI, with the GI as an indicator of how much and how soon a food increases blood sugar level. The review concluded that even after boiling, baking and steaming (most common ways of cooking grains) millets had lower GI than rice, wheat and maize.

“Millets are grown on all inhabited continents, yet they remain a ‘forgotten food’. We hope this will change from 2023, when the world observes the United Nations declared International Year of Millets, and with studies like this that show that millets outperform white rice, maize and wheat,” said Ms. Rosemary Botha, a co-author of the study who was based in Malawi at the time of the study, with the International Food Policy Research Institute (IFPRI).

“The global health crisis of undernutrition and over-nutrition coexisting is a sign that our food systems need fixing. Greater diversity both on-farm and on-plate is the key to transforming food systems. On-farm diversity is a risk mitigating strategy for farmers in the face of climate change while on-plate diversity helps counter lifestyle diseases such as diabetes. Millets are part of the solution to mitigate the challenges associated with malnutrition, human health, natural resource degradation, and climate change. Trans-disciplinary research involving multiple stakeholders is required to create resilient, sustainable and nutritious food systems,” said Dr. Jacqueline Hughes, Director General, ICRISAT.

Professor Paul Inman, Pro-Vice-Chancellor (International) of the University of Reading, stressed that “The rapidly accelerating threats of climate change and global health crises, including obesity and diabetes, require everyone to pull together in action. The partnership between ICRISAT and the University of Reading is doing exactly this, bringing together our world leading expertise in human nutrition with ICRISAT’s long established role as a leader in agricultural research for rural development.”

The study also identified information gaps and highlighted a need for collaborations to have one major diabetes study covering all types of millets and all major ways of processing with consistent testing methodologies. Structured comprehensive information will be highly valuable globally, taking the scientific knowledge in this area to the highest level.

“This study is first in a series of studies that has been worked on for the last four years as a part of the Smart Food initiative led by ICRISAT that will be progressively released in 2021. Included are systematic reviews with meta-analyses of the impacts of millets on: diabetes, anemia and iron requirements, cholesterol and cardiovascular diseases and calcium deficiencies as well as a review on zinc levels. As part of this, ICRISAT and the Institute for Food Nutrition and Health at the University of Reading have formed a strategic partnership to research and promote the Smart Food vision of making our diets healthier, more sustainable on the environment and good for those who produce it,” explained Ms. Joanna Kane-Potaka, a co-author from ICRISAT and Executive Director of the Smart Food initiative.

Millet cooked like rice 

CAPTION

Proso millet rice with turmeric.

CREDIT

Joanna Kane-Potaka

NOTE: This research is also part of a special edition and theme section in the Frontiers journal - Smart Food for Healthy, Sustainable and Resilient Food System.  

About the authors’ organizations/affiliations

ICRISAT: The International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) is an international agriculture research organization specialized in the drylands across Asia and Africa to ensure food, nutrition and income security, with global headquarters in India. www.icrisat.org. ICRISAT is a CGIAR research center.

IFNH: The Institute for Food, Nutrition and Health at the University of Reading in the UK, brings together the university’s world-leading expertise in food, nutrition, agriculture, health and the environment to help deliver better diets and health. https://research.reading.ac.uk/ifnh/

IFPRI: The International Food Policy Research Institute, part of the CGIAR, provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries. It is headquartered in Washington DC, USA. www.ifpri.org

NIN: The National Institute of Nutrition is India’s premier public research institute for nutrition. Headquartered in Hyderabad, NIN continuously monitors India’s nutritional health and works to manage as well as prevent nutritional problems. www.nin.res.in

Kobe University: One of Japan’s largest and oldest national universities. It is an institute of excellence for the social sciences and promotion of interdisciplinary research and education. www.kobe-u.ac.jp

Avinashilingam Institute for Home Science and Higher Education of Women (deemed to be University) is dedicated to higher education for women and has a specialization in a wide range of Home Science (including food and nutrition), Sciences, Arts, Commerce and Engineering based in India. https://avinuty.ac.in

NTBN: The National Technical Board on Nutrition advises the Government of India. It provides evidence-based, technical and policy recommendations and guidance for matters of nutrition.

CAPTION

Foxtail millet and barley salad.

CREDIT

Joanna Kane-Potaka